California LMFT Law and Ethics Exam

Legal: Can an LMFT omit or limit what records they release in regards to a subpoena?

No, only the client can request the court to narrow what is released.

Ethical: What is not appropriate for the therapeutic relationship?

1. can not enter into a contract that would incentive to withhold or limit care

Legal: what to do if you receive a subpoena

1. contact attorney 2. make sure subpoena is valid 3. contact client to see if they want therapist to claim privilege or the client may be fine to waive privilege 4. if from a judge it is considered a court order

Ethical: negative impacts of clinical obligation

1. could lead to distrust 2. could cause them to terminate care 3. take time away from clinical work when you have to do initial documentation for example

Legal: If you are covered by HIPAA you are required to:

1. designate privacy official 2. inform of privacy policy and procedures 3. discipline staff members who violate 4. repair harmful effects of violation 5. safeguard against release of information procedures for violations and complaints 6. protection of electronic stored data 7. protection against security threats 8. get client permission before communicating via unsecured email 9. Psychotherapy Notes: stored separate from clinical file. limited to notes and analyze the conversation. NOT start and stop time, not treatment plan, symptoms, interventions or prognosis. can be released for subpeona.

Legal: Release of record for support animal

1. must have 30 days relationship with therapist 2. inform client support animal is not service animal

Legal: What can a minor 12 and older consent to?

1. outpatient therpay (must contact parent , unless therapist deems it will not be helpful) 2. Crisis shelter (must contact parent)

Ethical: What are example of LMFT personal impairment ?

1. personal or psychologically issue (halt practice) 2. substance abuse (halt practice) 3. lack of competence around diversity issues (seek consultation) 4. countertransference 5. Environmental stressors 6. Compassion burnout

Ethical: When clients outside of therapy talk together about therapy what should be considered in this dual relationship?

Consider whether the clients' discussion of each other in therapy would impair clinical judgment or increase the risk of exploitation.

Ethical: Telehealth (RB, LC, AT, CTECH, WR3)

1. inform client of risks and benefits (confidentiality risks, tech fail, clinical limits) 2. make sure Telehealth is legally compliant 3. make sure it is clinically appropriate 4. both client and therapist should be comfortable and familiar with tech with available privacy 5. if session is recored must get consent in writing 6. If using recording for AI app must get written permission from client

Legal: what is privileged information

1. information that pertains to a court hearing or legal preceedings 2. outlined in California Evidence Code 1010-1027 3. exceptions are mandated reporting 4. Client holds their privilege 5. Judge make block waiver of privilege esp. with minors 6. therapist can never waive privilege

Ethical: What is scope of competence?

1. knowledge and training. 2. its important to remain current through education and clinical experience 3. maintain competence 4. maintain openness to new skills 5. stay informed for best practices for diversities

Legal: Where to report elderly abuse: 1. NOT in a long-term facility

1. law enforcement or APS by phone ASAP and then written within 2 days or if internet is avail only this ASAP

Ethical: Release of Records for referrals

1. outside our scope of practice or outside scope of competence 2. should have reasonable knowledge of local resources 3. can make referrals for functional needs like housing 4. use warm handoff to refer clients 5. Get ROI for referral (make sure to consider on-going collab) 6. follow-up with client

Legal: Reasons to report elder abuse

1. physical abuse (includes STD) 2. financial abuse 3. abduction (must be taken outside of California or not be allowed to come back) 4. Isolation 5. Abandonment 6. Neglect which includes self-neglect (wrong clothes) 7. Elder or dependent adult must reside in California

Ethical: What should you do to ensure ethical therapeutic relationship?

1. provide clinical treatment 2. utilize referrals and resources 3. consult and collaborate with other LMFTs 4. decisions ethical dilemmas 5. Identify the client by discussing, agreeing and documenting

Ethical: Signs of potential impairment

1. pulling punches (not taking effective steps out of lack of energy) 2. taking sides 3. clinical laziness 4. noticing your dislike or affection for a client 5. slips (like giving your personal opinion or engage in more self disclosure than is necessary)

Legal: what does HiPAA privacy rule entail

The Privacy Rule grants patients the right to inspect and receive a copy of their PHI; amend their PHI; receive an accounting of disclosures of their PHI; request restrictions on the disclosures of their PHI; request confidential communications; and receive a Notice of Privacy Practices

Legal: If a client sues you do you need their permission to release records for court proceedings?

When a client alleges breach of duty by a therapist, this is a specific exception to privilege set forth in state law. While the determination is ultimately up to a judge, the MFT should expect that they will be able to use their records from the client's care to defend themselves. None of the other listed actions are necessary or appropriate under the circumstances; the therapist has a right to defend themselves.

Ethical: how to evaluate if a dual relationship is appropriate?

1. risk of exploitive of clients trust or dependence (just bc you wouldn't exploit doesn't mean the risk isn't there, it has to be based on the risk not your intention to exploit) 2. impaired clinical judgement (are you able to evaluate this client on solely what they are bringing to you on their sessions, or do you know more info on them that would impact your knowledge about them and it will impact your ability to work with them will impair your judgement) exceptions: might be in a small town where you are the only available therapist. but with tele-health you could always refer them out for tele-health to avoid dual relationship

Legal: What is the order of priority for treatment?

1. safety 2. legal and ethical 3. Assessment 4. Diagnosis / treatment plan 5. Treat

Legal: What can a minor 12 and older not consent to? (S, M, H)

1. surgery 2. medication 3. voluntary hospitalization

Legal: What is scope of practice?

1. the application of family systems and psychotherapeutic theories, principles, and methods 2. to provide services to individuals, groups, or couples 3. to assess, evaluate and treat relational issues, emotional disorders, behavioral problems, mental illness, addiction, 4. to modify interpersonal and intrapersonal issues.

Legal: Request for records rules

1. the employer owns the records 2. but clients have legal right to access those records 3. if therapist thinks it is harmful to release they must document request, refusal and reason why and inform client they have right to appeal 4. client has right to add to records but not the right to alter existing records 5. can release records without a release if with another active treatment provider or for billing 6. all that could consent even if they originally did not must consent for release of records (ex a minor that was consented by parent) 7. do not have to release records to other states regarding abortion etc. 8. third party release must be in writing 9. Would never request a ROI so you can talk about client without a clinical reason that is beneficial to the client (i.e. a ROI so you could talk to your partner)

Ethical: Collaboration and Consolation guidelines

1. treat coworkers with respect 2. assist coworkers who are impaired 3. take reasonable steps to resolve conflict before making a complaint 4. do not file frivolous complaints 5. stay true to your scope of competence 6. Only share necessary information and avoid indenfying information without consent ( you can legally consult for diagnosis, treatment plan etc, but ethically its nice to consult client)

Legal: Under what circumstances can an MFT apply psychological testing, therefore acting outside of scope of practice?

1984 attorney generals stated the following: 1. adequate training for the tests you will be using. 2. must be part of a counseling process

Ethical: What is duplicate services or concurrent psychotherapy?

Principle 5.12 of the CAMFT Code of Ethics states that "marriage and family therapist do not generally duplicate professional services to a prospective client/patient receiving treatment from another psychotherapist. When making a determination to provide services, marriage and family therapists carefully consider the client's/patient's needs, presenting treatment issues, and the welfare of the client/patient to minimize potential confusion and/or conflict. Prior to rendering services, marriage and family therapists discuss these issues with the prospective client/patient, including the nature of the client's/patient's current relationship with the other treating psychotherapist and whether consultation with the other psychotherapist is appropriate."

Legal: What age restrictions require mandated report from LMFT for sexual abuse?

age 14-15 is reportable if slept with 13 and younger age 14-15 reportable is slept with over 20 age 16-18 not reportable unless 13 and younger age 14-15 lewd & lascivious mandated partner is 10+ years older 13 and younger: lewd & lascivious mandated if partner is over 14 LMFT not legally required to ask age of client's partner

Legal: Who can authorize a 51/50 hold?

anyone appointed by the county. WIC Section 5150 states that "a peace officer, a member of the attending staff of an evaluation facility designated by the county, designated members of a mobile crisis team, or other professional person designated by a county, may upon probable cause, take, or cause to be taken, the person into custody and place him or her in a facility designated by the county and approved by the State Department of Mental Health as a facility for 72-hour treatment and evaluation."

Ethical: Boundaries

1. LMFT should set boundaries 2. should be in best interest of the client safeguard against exploitation 3. clear consent 4. police around in between sessions 5. clarify non-therapy roles 6. openly discuss clients pushing boundaries 7. obtain supervision or consultation when needed 8. physical touch take into consideration culture etc.

Legal: What is legally true for unprofessional sexual conduct?

1. MFT can not sleep with a current client 2. If they end their therapeutic relationship they must wait 2 years 3. Can not solicit sexual relations ** If these are violated BBS will revoke your license.

Legal: All 3 is required to NOT report elderly abuse?

1. a mental illness that impairs cognition like dementia 2. no supporting evidence 3. LMFT does not believe abuse occurred

Ethical: breach of confidentiality

1. inform client 2. ensure doesn't happen again 3. discipline employee 4. with 3rd party payment: advise client what information is released, info is truthful and accurate (need minor consent even if parent consented but minor could have consented)

Legal: Who is the holder of privilege in regards to a minor during a custody battle.

The child is, unless a guardian ad litem is assigned. Judge can rule against a child waiving their privilege.

Legal: does an MFT have to provide client information during a pandemic .

They do not legally have to , but they may.

Legal: Do prelicensed and licensed MFTs have the same scope of practice?

Yes

Ethical: attraction alone requires what step in a therapeutic relationship

assess it interferes

Legal: What is an exception to confidentiality for all past acts involving a minor reporting?

child abuse

Legal: Rules of Confidentiality

1. any information about a client even if you leave their name out 2. mere existent of relationship with client is confidential 3. Disclose only necessary information 4. not legally obligated to tell client about disclosures 5. Document disclosure and reason 6. For group therapy: individual notes without names of other group members 7. Couple and family every one must consent for information to be released to others

Legal: what can not be in psychotherapy notes?

diagnosis, admin info, legal data, shared with 3rd parties without court order or waive of confidentiality (i.e. insurance), incidental observations like appearance or behavior

Ethical: What are some of the unethical things when regarding dual relationships and business opportunities

entering into any business deal during or before a reasonable amount of time following termination.

Ethical: Client Safety Considerations

1. history of previous suicide, violence etc. 2. statements they make 3. Client behavior (giving away possessions in case of suicide) 4. assessing danger to client (harm to self, harm from others) 5. assessing their immediate shelter and safety needs. 6. is the situation solved 7. provide information during public emergencies 8. Consult when in doubt

Legal: timeframe for record release

1. if client has made a request in writing you have 5 days to provide access to inspect records 2. if client wants a treatment summary you have 10 days to provide 3. if they want a paper or digital copy of records you have 15 days

Legal: What are reasons a person can be involuntarily hospitalized?

1. imminent harm to self 2. imminent harm to others 3. gravely disabled

Legal: Unprofessional conduct falls under what type of law?

1. Administrative law as opposed to criminal or civil law. meaning they can punish you by effecting your privilege to be licensed but not that you can be sued or go to jail. 2. BBS can start proceedings against LMFT term-78 3. can be criminal also if related to duties, functions or qualifications. (for ex. DUI for LMFT)

Ethical: What not to do to increase scope of competence

1. Ask client to educate you 2. hold to presumptions 3. assume knowledge about demographics equals knowledge about the person

Ethical: How should MFT increase their scope of competence for diversity

1. CE course 2. Read ethnography and 3. Research articles, podcasts, other media 4. lived experience/exposure 5. personal therapy

Ethical: What must be included in the summary of a client's health record?

1. Chief complaint or complaints including pertinent history. 2 Findings from consultations and referrals to other health care providers. 3 Diagnosis, where determined. 4 Treatment plan and regimen including medications prescribed. 5 Progress of the treatment. 6 Prognosis including significant continuing problems or conditions. 7 Pertinent reports of diagnostic procedures and tests and all discharge summaries. 8 Objective findings from the most recent physical examination, such as blood pressure, weight, and actual values from routine laboratory tests.

Legal: true informed consent 3 conditions that must be met

1. Client must have the capacity to understand 2. Comprehension ( must contain all necessary information) 3. Must be done voluntarily .

Ethical: Documentation of Records

1. Consistent with sound clinical judgment 2. Consistent with standards of profession 3. Consistent with Nature of services rendered 4. Ensure documents are secure (using EHR, multiple lock and key levels, controlling access) 5. Major change to treatment plan 6. Change in unit size (must start new record not add to previous individual one) 7. Significant decisions effecting treatment 8. when released to client make sure to put in easy to understand language, go through with client, explain why we keep records, give list of terms and abbreviations, be available for questions 9. Companies need a Business Associate Agreement to move records from one location to another

Ethical: Managing Safety (always do the least invasive if not imminent safety need)

1. Continue to assess 2. Consult with treatment team 3. more detailed assessment 4. make a safety plan 5. Increase sessions or contact 6. involve friends or family 7. refer to higher level of care 8. voluntary hospital 9. involuntary hospital

Ethical: When faced with not knowing which standard to use legal or ethical what should you do?

1. Defer to the higher level of standard, but if conflict couldn't be solved you must follow the law. 2. for ex. Confidential release is allowed by law but not required by law and does not involve safety, ethics standard maybe better to get ROI. 3. Agency policy contradicts with ethics or law. In this case, you need to make known your ethical obligations and must make responsible steps to resolve the problem.

Legal: Documentation of Records

1. Must be kept 2. Consistent with sound clinical judgment 3. Consistent with standards of profession 4. Consistent with Nature of services rendered 5. Records must be kept 7 years after termination 6. Minor records must be kept until they are age 25 7. Records must be destroyed to protect confidentiality

Legal: Confidentiality of a Minor 12 and older can consent to and informing parents.

1. Outpatient care: Parent must be contacted unless deemed bad for client 2. Shelter service: Parent must be contacted 3. infection disease, AIDS,: not permitted to contact parents without consent 4. Drug: if it is federal drug program or medical not permitted at. all...if non federal it is at the discretion of the LMFT

Legal: Parity and third party payments:

1. Parity are insurance laws (must be on par with other forms of health care) 2. insurance only required to cover mental health disorders 3. protests and complaints (LMFT should advocate for client) 4. Client has freedom of choice of provider 5. avoid insurance fraud like claims, documentation, and diagnosis

Ethical: Nonprofessional Interactions

1. Sexual relationship are prohibited with all former and current clients and any of their immediate family or friends 2. After two years of termination there can be a sexual relationship. 3. Must keep in mind continued vulnerability and exploitation of clients we no longer see. 4. Consequences of interacting with former clients....risk their ability to participate in future therapy 5. Derogatory language can be considered harrassment

Legal: How to report a child abuse ?

1. The report must be made as soon as possible by telephone 2. A written follow-up report within 36 hours. 3. When a reporter is unable to make the initial report by telephone, after making a reasonable effort to do so, he or she must submit a written report by fax or electronic transmission and be available to respond to a follow-up call by the agency 4. Internet Report if possible (written not required then)

Legal: What are the applications and methods within the scope of practice?

1. assessment, evaluation and prognosis a. understand the biopsychosocial aspects b. clinical interviews, observations, history c. understand presenting problems, symptoms, d. underlying issues to inform the diagnosis e. severity, duration of issues f. likely path of recovery g. support systems, h. prediction of outcome 2. treatment, planning and evaluation a. definition: which model, interventions will be used. b. Process is collaborative for goals, treatment plan, c. monitor progress and adjust as needed 3. individual, family, couple and group interventions a. deciding which type to utilize 4. relational therapy a. using a systemic approach 5. psychotherapy a. psychotherapist are mandated reports b. you can advertise as a psychotherapist c. (general attorney 1984) since testing is an applied psychotherapist technique you can use psychological testing if you are trained and in a counseling relationship 6. client education 7. clinical case management 8. consultation 9. supervision 10. use, application, and integration of the coursework and training (including training to diagnose)

Legal: when can HIPAA be violated

1. authorization form 2. TPO:treatment payment and healthcare 3.Public health activities like disease control 4. audits, investigations, inspections 5. judicial proceedings 6. law enforcement purposes 7. emergency circumstances

Ethical: How to practice non-discrimination

1. avoid social prejudices and pathologizing clients 2. make sure you are culturally competent around a. informed consent b. consider multiple relationships (is this considered appropriate within the culture) c. giving/receiving gifts d. bartering e. how identity effects goals

Ethical: What are ways you can manage your values, attitudes and beliefs?

1. be aware 2. develop competence and areas of difference 3. assess for unconscious bias 4. seek consultation and supervision

Ethical: How do personal values, attitudes, and beliefs impact therapy?

1. can impact what methods you choose 2. can impact 3. goals you're willing to work on 4. experience of the client do they feel accepted or judged does it feel warm or cold 5. can make client feel like somethings are safe and some are not 6. presence of bias or discrimination *** can not exert undue influence from your values, attitudes and beliefs on your clients

Legal: Advertising Restrictions:

1. can not make scientific claims that are not peer reviewed 2. if talk about fees it must be accurate 3. can advertise a sliding scale fee 4. Must include name, license title, and registration # 5.AMFT: must include supervisor 6. Ok to say psychotherapy and psychotherapist 7. Fictitious names must include owners name, licensure status and not be misleading. considered unprofessional conduct if anything is false.

Ethical: What is considered accurate representation in advertising?

1. can't be false or misleading 2. accurately represent training, education and experience 3. Can not use a misleading name or false affiliations 4. correct misrepresentations by others 5. Can call yourself a specialist only if you have the appropriate training, education and experience 6. If you advertise CMAFT membership must list status 7. If you are employing others you are labeling them accurately 8.

Legal: 1. what is the Bellah vs Greenson case? 2. what is Tarasoff vs California board of regents? 3. Ewin vs Goldstein?

1. case that established MFT to prevent suicide 2. to inform potential victims of imminent harm of severe bodily harm (must warn victims or talk client out of it but must also inform law enforcement within 24 hours even if issue is resolved) 3. allows MFT to consider third party information when considering a mandated report

Legal: What are the 6 exceptions to privilege

1. client makes their mental or emotional condition an issue in a lawsuit 2. client alleges breach of duty by therapist 3. evaluation or therapy is taking place by court order 4. defendant in criminal case requested evaluation or therapy in order to determine their sanity then they have to release record even if they don't like the results 5. client is under 16 and a victim of crime and releasing records would be in clients best interest 6. therapist sought out for crime or avoiding detection

Ethical: Client Autonomy

1. collaborative core a. work together to define & achieve goals b. avoid imposing values, beliefs, and attitudes c. remind clients major life decisions are theirs to make 2. right to make treatment choices a. even if they are court ordered 3. Appropriate assisting with life decisions (like motivational interviewing, reviewing options together and consequences and affect on others, and giving input but decision up to client)

Ethical: Rules of Confidentiality

1. do not break unless required by law 2. all family or couple must consent before release 3. store and rid of records in proper way and ensure employees do as well 4. MUST inform group members to respect each others confidentiality 5. SHOULD get written consent from group members to respect confidentiality 6. do not use client info in learning material without written consent 7. Make clear the limits of confidentiality 8. If you must break, discuss with client if possible 9. regular reminders of limits of confidentiality 10. share only minimum info when breaking

Legal: What is the definition of Gravely Disabled?

1. due to mental illness or severe substance abuse can not provide basic needs a. food b. safety c. shelter d. clothes e. medical care poverty, homelessness, and poor health are not gravely disabled.

Ethical: What to do if a coworker is impaired?

1. encouraged to provide consultation to coworker with substance use or mental disorder 2. you may file ethics complaint 3. you may talk to supervisor (but ethics says to take reasonable effort fore doing this) ** following least intrusive means necessary

Ethical: ways to ethically work in a dual relationship

1. get consent from client 2. document your analyze why you made the decision 3. seek supervision or consultation 4. appraise the risks and benefits involved 5. determine the feasibility of alternatives 6. set clear and appropriate boundaries

Legal: What is outside MFT scope of practice?

1. give medical advice 2. give legal advice

Legal: Who is considered a covered entity for HIPAA (HP, CH, EHHS)

1. health plans 2. health care clearinghouses 3. health care providers who electronically transmit any health information in connection with transactions for which HHS has adopted standards.

Legal: Where to report elderly abuse: 2. State hospital or state developmental center (2hr, state ? OR LP)

2. within 2 hours Investigators of the State Dept of State Hospitals or State Dept of Developmental Services, OR local law enforcement.

Ethical: What do you need to ethically provide during Informed Consent

Ethically Required: 1. right to enter, leave or remain in therapy 2. must provide clear understandable language 3. consent can be verbal unless there is third party observation then it must be written 4. risks/benefits of novel/ experimental treatment 5. risk of harm from specific techniques 5. emergency in-between session contacts 6. Responsibility to offer alternatives both in and out of insurance plans 7. Rights and Responsibilities of client Ethically Encouraged: 1. limits of confidentiality 2. professional background 3, Risks and Benefits

Legal: Where to report elderly abuse: 3. death, sexual assault, genital damage, broken bone in state center

3. within 2 hours State Dept of State Hospitals or State Dept of Developmental Services, AND local law enforcement

Legal: Where to report elderly abuse: 4. Non-state long-term facility

4. Verbal report within 2 hours to local law enforcement, AND file written reports within 24 hours to the long-term care ombudsperson, local law enforcement, and the facility's state licensing

Legal: Where to report elderly abuse: 5. abuse in non-state by dementia patient with no injury

5. File written reports within 24 hours to the long-term care ombudsperson and local law enforcement.c

Legal: Confidentiality for Minors: releasing records to parents

Even if a Parent consents to care the therapist can use their best judgement whether or not to release records for the minor.

Legal: Who can consent for a minor?

Adult Caretaker: With letter from parent, or with caregiver consent affidavit Guardian: With court order granting guardianship Court: Minors 16 and over whose parents are unavailable Juvenile court: Minor 16 and younger who is a dependent of court Foster Parent: Only with dependency court permission (otherwise they can not give consent with mention of court permission) Emergency: Consent not required

Legal: Requirements at each new session (AT, CNL, SC)

At every session of telehealth A. Must determine the appropriateness for Telehealth B. Document client full name and location C. Follow best practices for security and confidentiality.

Legal: Requirements for Telehealth at first session (RL, CC, VC, LR)

At first instance of use of telehealth: A. can not provide Telehealth in another state unless carve-outs B. give risks and limitations C. document local crisis center D. get consent E. provide license and registration

Legal: Do you need direct knowledge to make a child abuse report?

No, you just need reasonable suspicion.

Legal: Who is considered an elder and a dependent adult?

Dependent Adult: 1. anyone that is hospitalized 2. has special needs 3. age 18-64 4. resides in CA 5. 24- hour in patient facility Elder: 1. Over 65 2. Resides in CA

Legal: What does HIPAA stand for? what is PHI?

Health Insurance Portability and Accountability Act: federal law for PHI (protected health information) SS# address birthdate name medical history

Ethical: Advertising what is the exception to soliciting testimonials?

If client is "subject to undue influence" * Make sure to explain the implications of testimonials and get their permission.

Legal: When must brochure "Therapy Never Includes Sexual Behavior" be used?

If client reports sexual relationships with previous therapist.

Legal: When can a therapist refuse to testify?

If the therapist is not subpoena'd or court ordered and believes it is not in the clients best interest. If the client does not waive confidentiality However, if the client does waive confidentiality the therapist has no choice but to testify.

Legal: What do you legally need to provide during Informed consent

Legal: 1. must get verbal consent 2. disclose fee 3. license and registration info 4. privacy policy 5. good faith estimate for non insurance 6. BBS complaint procedure 7. if there will be use of Telehealth

Legal: What must and may be reported as child abuse?

MUST BE: 1. Physical abuse 2. Sexual abuse (includes digital) 3. Willful harm or injury (not stepping in, left in hot car) 4. Unlawful corporal punishment or injury 5. Neglect. 6. Out-of-home abuse (daycare) MAY MAKE: reasonably suspect, "that a child is suffering serious emotional damage or is at a substantial risk of suffering serious emotional damage, evidenced by states of being or behavior, including, but not limited to, severe anxiety, depression, withdrawal, or untoward aggressive behavior toward self or others, may make a report."

Ethical: What should an LMFT do if their values are prejudicial in diagnosis or in limiting treatment?

Must disclose that information to client or provide referrals.

Legal: Can clients share their experience on public forums

Yes the client owns their confidentially and can do with it as they please, so long as the therapist is not putting undue pressure on them to advertise for the therapist, if they are vulnerable to undue experience

Legal: Is it legal to have a referral network and utilize coupons?

Yes, as long as all fees are disclosed. ***It is unprofessional conduct to get any form of payment or gifts for referrals

Ethical: examples of dual relationships that could be unethical...

hiring a client borrowing money from a client engaging in business with a client engaging in a close personal relationship with a client engaging in a relationship with a spouse, partner or immediate family member of a client

Legal: When there is a fight between children is this considered abuse?

if the people are the same age and size and the fight is mutual it is not considered abuse and must be kept confidential. If the fights are not mutual then it is a reportable offense.

Legal: Is there a legal obligation to report damage to property

no, only to self or others

Ethical: What are considered areas of discrimination?

race ethnicity national origin gender Indigenous heritage sexual orientation immigration status gender identity gender expression religion age disability SES relational status *can not refuse service on any of these reasons or condone discrimination

Ethical: Sexual Conduct

same as legal and 1. prior sexual relationship prohibits future therapist relationship 2. including superiors and students

Ethics: Is it allowed to recruit clients

yes as long as they are not subject to undue influence.